Relationship Between Clinical and Laboratory Findings and Hospital Admission in Cellulitis Patients Presenting to the Emergency Department

Öz

 Background: Cellulitis is a bacterial infection of the skin and subcutaneous tissues and represents a substantial proportion of emergency department visits. This study aimed to identify independent clinical and laboratory predictors of hospitalization among cellulitis patients presenting to a tertiary emergency department.

Materials and Methods: Adult patients (≥18 years) diagnosed with cellulitis between January 1, 2019, and January 1, 2025, were retrospectively analyzed. Demographic, clinical, and laboratory parameters were evaluated. Multivariable logistic regression analysis was performed to determine independent predictors of hospitalization. ROC analysis was performed for variables retained as independent predictors in the multivariable model.

Results: A total of 162 patients were included. The mean age was 51.1±19.3 years, and 57.7% were male. Overall, 52.5% of the patients (n=85) were hospitalized, while 47.5% (n=77) were managed as outpatients. Among the comorbidities, diabetes mellitus (22.1%) and hypertension (16.6%) were prominent. Inflammatory markers were significantly higher in hospitalized patients (p<0.05, for all). In multivariate logistic regression analysis, C-reaktif protein (CRP) [odds ratio (OR): 1.06; 95% confidence interval (CI): 1.00-1.12; p=0.033], hemoglobin (OR: 0.75; 95% CI: 0.59-0.95; p=0.016), and platelet count (OR: 0.995; 95% CI: 0.991-0.999; p=0.014) were identified as independent predictors of hospitalization. In the ROC analysis, CRP was found to have the highest AUC value (AUC=0.692; 95% CI: 0.608-0.776; p<0.001).

Conclusions: CRP was found to be an independent predictor of hospitalization in patients with cellulite. Laboratory parameters added to the clinical evaluation can provide a supportive risk classification in the hospitalization decision.

Anahtar Kelimeler

• Cellulitis
• C-reactive protein
• Emergency department

Acil Servise Başvuran Selülit Hastalarında Klinik ve Laboratuvar Bulgularının Hastaneye Yatış ile İlişkisi

Öz

Amaç: Selülit, deri ve subkutan dokuların bakteriyel enfeksiyonu olup acil servis başvurularının önemli bir kısmını oluşturmaktadır. Bu çalışmada, üçüncü basamak bir sağlık kuruluşunun acil servisine başvuran selülit olgularında hastaneye yatış gereksinimini öngörebilecek klinik ve laboratuvar parametrelerin değerlendirilmesi amaçlanmıştır.

Materyal ve metod: 01 Ocak 2019-01 Ocak 2025 tarihleri arasında Harran Üniversitesi Hastanesi Acil Servisine başvuran, 18 yaş üzeri selülit tanılı olgular retrospektif olarak incelendi. Hastaların demografik, klinik ve laboratuvar bulguları analiz edildi. Yatış gereksinimi ile ilişkili değişkenler lojistik regresyon analizi ile değerlendirildi. Çok değişkenli modelde bağımsız prediktör olarak kalan değişkenler için ROC analizi yapıldı.

Bulgular: Çalışmaya 162 hasta dahil edildi. Ortalama yaş 51,1±19,26 olup, olguların %57,7’si erkekti. Hastaların %52,5’i (n=85) hastaneye yatırılırken, %47,5’i (n=77) ayaktan takip edildi. Komorbiditeler arasında diyabetes mellitus (%22,1) ve hipertansiyon (%16,6) öne çıktı. Yatış gerektiren hastalarda inflamatuvar belirteçler anlamlı olarak daha yüksekti (p<0,05, hepsi için). Çok değişkenli lojistik regresyon analizinde C-reaktif protein (CRP) [odds raito (OR): 1,06; %95 güven aralığı (GA): 1,00-1,12; p=0,033)], hemoglobin (OR: 0,75; %95 GA: 0,59-0,95; p=0,016) ve trombosit (OR: 0,995; %95 GA: 0,991-0,999; p=0,014) yatış gereksiniminin bağımsız öngördürücüleri olarak saptandı. ROC analizinde, CRP’nin en yüksek AUC değerine sahip olduğu görüldü (AUC=0,692; %95 GA: 0,608-0,776; p<0,001).

Sonuç: Selülit hastalarında CRP, hastane yatışını öngörmede bağımsız bir belirteç olarak tespit edildi. Klinik değerlendirmeye eklenen laboratuvar parametreleri, yatış kararında destekleyici bir risk sınıflaması sağlayabilir.

Anahtar Kelimeler

• Selülit
• C-reaktif protein
• Acil servis

Kaynakça

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